Your answers to these questions will guide us in recommending the best products
to meet your eyewear needs.

My prescription glasses.

My prescription sunglasses.

My contact lenses.

For Reading/Working:

My prescription glasses.

My prescription sunglasses.

My contact lenses.

For Driving:

My prescription glasses.

My prescription sunglasses.

My contact lenses.

For Sports or Outdoor Recreation:

My prescription glasses.

My prescription sunglasses.

My contact lenses.

Which do you do regularly?

Check all that apply.

Night Driving

Work Outdoors

Commute 20+ min. By Car

Work w/ Small Objects

Work Under Fluorescent Light

Read For Long Periods

Work on a Computer

Travel on Airplanes

Watch TV for 3+ hrs/Day

Work at a Desk

Frequently Alternate Between Indoors & Outdoors

Hobbies/Recreation:

Spend time at the cottage in the summer? Read a lot by the water? Spend time sewing or golfing? Maybe you are on tour with your band? We would love to know how YOU keep busy!

What do you like about your current glasses?

What is important when choosing your new glasses?

Please check all that apply.

Image

Frame Material

Fit

Durability

Weight

Brand

Fashion Trends

Lens Type

Lens Thickness

Frame Colour

Lens Colour

Can we stay in touch? *

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Trunk Shows – Events that feature exclusive new and upcoming brands
Promotions – Exclusive friend’s and family opportunities to save
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